Healthcare Provider Details

I. General information

NPI: 1265948582
Provider Name (Legal Business Name): RACHEL GRAVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2017
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 N GALLATIN ST
LIBERTY MO
64068-1668
US

IV. Provider business mailing address

202 E BROWN ST
LIBERTY MO
64068-2410
US

V. Phone/Fax

Practice location:
  • Phone: 816-810-6597
  • Fax:
Mailing address:
  • Phone: 816-810-6597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: